| Specimen requirement | Adult patient: Special clotted blood tube for aluminium Minimum blood volume: 5 mL |
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| Paediatric patient:
Special clotted blood tube for aluminium Minimum blood volume: 3 mL |
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| Authorisation code required | Yes | |||||||||||||
| 24 Hr available service | No | |||||||||||||
| Precaution | Prone to contamination. Powder inside plastic gloves can be a source of aluminium contamination when handling samples. | |||||||||||||
| Method | Inductively coupled plasma-mass spectrometry (ICP-MS) | |||||||||||||
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Reference interval |
Serum:
(Source: Supra-Regional Assay Service (SAS), UK |
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| Clinical indication | Monitoring renal dialysis patients. Investigation of dementia, osteodystrophy or unexplained anaemia in renal dialysis patients. | |||||||||||||
| Result interpretation |
Aluminium is not thought to be an essential trace element but it is clinically relevant because it can accumulate in patients with renal disease. Tap water containing aluminium in amounts from 50 to over 1,000 µg/L can cause a toxic syndrome in uraemic patients when this water is used during dialysis. The syndrome can present variably as encephalopathy (dialysis dementia), hypercalcaemic osteomalacia, and microcytic anaemia. Excessive prescription of aluminium-based phosphate binders can also cause bone disease in some renal patients who may be hyperabsorbers of oral aluminium. Contaminated intravenous fluids such as protein hydrolysates and various plasma protein fractions are another potential cause of aluminium toxicity. The accumulation of aluminium in brain tissue has been linked to the pathogenesis of Alzheimer's disease, however, the evidence for this remains controversial. |
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| Measurement of uncertainty | See table. | |||||||||||||
| Frequency of measurement | Weekly |